Tuesday, November 15th, 2011 - 15:36
Tuesday, November 15, 2011 - 14:55
Administration officials make presentation entitled "Implementation of the Affordable Care Act" to University of Maryland School of Public Policy's faculty and students.
On Tuesday, two members of the Department of Health and Human Services' Office of Health Reform made a special trip to the University of Maryland to update the School on the status health reform law. Jennfer Cannistra, J.D. and Kristin Young, J.D. of the aptly named Office of Health Reform shared their intimate knowledge of the many facets of the Affordable Care Act.
Ms. Cannistra and Ms. Young outlined three major part to implementing health reform in the upcoming years. The initial focus of the Obama administration is on near term (pre-2014) insurance market reforms. Highlights include the following:
"Bridge to 2014 Plans"
- Preexisting Condition Insurance Plan - high risk pool established with 34,000 enrollees to date
- Early Retiree Reinsurance Programs" - encourage companies to insure 55-64 year olds who otherwise would end up on individual insurance market, 4.5 million or more beneficiaries
- Coverage for Young Adults extended until age of 26 - benefits 1 - 2.5 million
- Children's Preexisting Condition Exclusions Forbidden - coverage cannot be denied to children
Other insurance market reforms:
- Annual limits being phased out
- Preventative services required
- Insurer standards such as medical loss ratios and rate reviews, supported by $250 million in federal funding
The Office of Health Reform is also looking ahead to the 2014 "go" date, which is when Exchanges are expected to be up and running by and large. By 2019, studies project 24 million Americans will be enrolled in insurance plans through the Exchanges. At the same time, the Administration will be flexible with states that are not ready, allowing those states to elect a federal plan, submitting their own plan in subsequent years. The ACA also focuses on providing coverage for employees of small businesses through a mechanism called the Small Business Exchange (SHOP) which provides tax credits for small business owners who purchase coverage for their employees on this Exchange.
Implementation of the ACA also looks to alternative ways to offer Americans health coverage including Consumer Oriented and Operated Plan, or CO-OPs. These nonprofit, member owned health plans are being supported with $4 billion in repayable federal grant money. The Administration is marketing CO-OPs as more competition for private insurers, another option for consumers, and a way to control rising health insurance premiums.
The MSPP community will continue to look for opportunities to interact with the Office of Health Reform and other leaders on the topic of Making Health Care Reform Work.